The long term objective is to develop and test a Patient Classification System (PCS) for use in ambulatory care. PCSs are important for determining nurse staffing levels, establishing costs of care, variable billing for nursing services, studying trends in patient needs for nursing care, and providing a framework for nursing practice. While there are many PCSs in hospitals, few have been developed or adapted for use in ambulatory care which is one of the fastest growing areas of health care. The use of ambulatory care is expected to increase due to fiscal pressures and efforts to shift the escalating costs of inpatient health care. To effectively and efficiently meet the growing demand, administrators need reliable and valid measures of nursing intensity which are sufficiently versatile to serve several purposes and also appropriate for the diverse types of patient populations and health care services seen in ambulatory care settings. Dr. Prescott has developed a conceptually derived and psychometrically tested inpatient measure of nursing intensity, the Patient Intensity for Nursing Index (PINI). This project will adapt and test the Patient Intensity for Nursing: Ambulatory Care (PINAC) for reliability in six ambulatory care clinics located within a major teaching hospital.